Application of vagus nerve-guided robotic splenectomy and azygoportal disconnection
10.3760/cma.j.cn113884-20230304-00060
- VernacularTitle:以迷走神经为导向的机器人脾切除联合断流术的应用研究
- Author:
Guoqing JIANG
1
;
Dousheng BAI
;
Baohuan ZHOU
;
Jianjun QIAN
;
Shengjie JIN
;
Chi ZHANG
Author Information
1. 扬州大学临床医学院肝胆外科，扬州 225001
- Keywords:
Liver cirrhosis;
Portal hypertension;
Robot;
Vagus nerve;
Splenectomy;
Azygoportal disconnection
- From:
Chinese Journal of Hepatobiliary Surgery
2023;29(8):599-604
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate whether vagus nerve-guided robotic splenectomy and azygoportal disconnection (VNRSD) is feasible and safe and to determine whether VNRSD can be competent for well protecting vagus nerve.Methods:In this prospective clinical study, 12 cirrhotic patients with portal hypertension, hypersplenism and esophagogastric variceal bleeding (EVB) who accepted VNRSD at the Clinical School of Medicine of Yangzhou University between January 2022 and March 2022 were included, including 5 females and 7 males, aged (56.6±11.6) years old. Clinical data such as visual analog scale (VAS) pain score, conversion to laparotomy, esophagogastric variceal bleeding, and death were collected. The patients were asked to reexamine in the outpatient department 1 month after the operation, and the diarrhea, delayed gastric emptying and epigastric fullness were followed up.Results:VNRSD was successfully performed in all patients. There was no conversion to open or laparoscopic operations. The operation time was (170.0±16.8) min, blood loss was (60.8±11.3) ml, VAS pain score on the first day was (2.2±0.9) scores, and the postoperative hospital stay was (7.7±0.7) d, the four patients had main portal vein system thrombosis on the 7th day after operation. At the first day after operation, all patients were mange to take semi-fluid and off-bed activity. There were no incisional complications, pneumonia, gastric fistula, pancreatic fistula, and abdominal infection. No patients suffered from diarrhea, delayed gastric emptying, and epigastric fullness. None of the patients suffered from esophagogastric variceal bleeding, hepatic encephalopathy or death after operation and one month after operation, and the esophagogastric variceal were significantly improved. And no patient complained of abdominal distension or diarrhea.Conclusion:VNRSD procedure is not only technically feasible and safe, but also effectively protects anterior and posterior vagal trunks and all their branches, completely eradicating digestive system complications.
